oxychlorosene and Cystitis

The treatment of interstitial cystitis is difficult and at time frustrating--both for the patient and for the physician. Treatment is hampered by the lack of a clear understanding of its pathophysiology, which makes it difficult to objectively assess disease severity and/or progression. Intravesical therapy appears to be the most successful approach to the relief of symptoms. Clearly, there are drawbacks to intravesical therapy, particularly Clorpactin lavage. Responses to intravesical lavage are variable in duration, unpredictable, and unamenable to objective measurement. Multiple treatments are frequently needed, as with DMSO, and multiple anesthetics may be required for Clorpactin therapy. There have been no double-blind, placebo-controlled studies comparing the mainstays--Clorpactin and DMSO--of intravesical treatment. It is hoped that current research into the pathogenesis and causation of interstitial cystitis will lead to an improved understanding of this disease or syndrome. The introduction of newer, more specific intravesical therapies will surely follow such advances.

Topics: Administration, Intravesical; Anti-Infective Agents; Benzenesulfonates; Cystitis; Decision Trees; Dimethyl Sulfoxide; Humans; Silver Nitrate; Surface-Active Agents

Topics: Administration, Intravesical; Administration, Oral; Amitriptyline; Azathioprine; Benzenesulfonates; Benzydamine; Chloroquine; Cystitis; Heparin; Histamine H1 Antagonists; Humans; Hydroxychloroquine; Pentosan Sulfuric Polyester; Prednisolone; Silver Nitrate

Topics: Adult; Autoimmune Diseases; Benzenesulfonates; Cystitis; Cystoscopy; Dimethyl Sulfoxide; Electric Stimulation Therapy; Female; Humans; Male; Middle Aged; Pentosan Sulfuric Polyester; Ulcer; Urinary Bladder

A defective barrier between the urine and urothelium has been suggested as an etiology for interstitial cystitis. With immunohistochemical techniques we assayed the bladder biopsies of 14 interstitial cystitis patients and 10 normal controls for intraurothelial Tamm-Horsfall protein to assess indirectly the in vivo permeability of the urothelium. Eight pathological controls, including bladder biopsies from 3 patients with inflammation owing to infection or catheterization and biopsies of 5 transitional cell carcinomas of the bladder, also were assayed. Superficial intraurothelial Tamm-Horsfall protein was identified in the biopsies from 10 of 14 interstitial cystitis patients (71 per cent) but only 1 of 10 controls (10 per cent) (p less than 0.01). Tamm-Horsfall protein was not identified in biopsies from the pathological controls. In 6 of 7 cases when more than 1 biopsy was available for analysis the findings were identical in each specimen. There was a direct correlation between the density of detrusor mast cells and the demonstration of intraurothelial Tamm-Horsfall protein. Seven of the 9 evaluable interstitial cystitis patients with intraurothelial Tamm-Horsfall protein but only 1 of 4 without intraurothelial Tamm-Horsfall protein experienced a favorable response to intravesicle oxychlorosene sodium (p greater than 0.05). These data suggest that abnormal permeability of the urothelium is associated with and a possible cause of interstitial cystitis and that the demonstration of intraurothelial Tamm-Horsfall protein in bladder biopsy specimens may prove to be useful as a diagnostic test for interstitial cystitis.

Topics: Administration, Intravesical; Adult; Aged; Anti-Infective Agents, Urinary; Benzenesulfonates; Biopsy; Cystitis; Endothelium; Female; Humans; Immunohistochemistry; Male; Middle Aged; Mucoproteins; Urinary Bladder

Topics: Administration, Intravesical; Benzenesulfonates; Cystitis; Cystoscopy; Diagnosis, Differential; Dimethyl Sulfoxide; Female; Histamine H1 Antagonists; Humans; Male; Therapeutic Irrigation

A case of ureteral fibrosis complicating Clorpactin WCS90 treatment for interstitial cystitis in a patient with vesicoureteral reflux is presented. The results of a laboratory experiment designed to study the effects of Clorpactin WCS90 on refluxing ureters are discussed.

Topics: Animals; Anti-Infective Agents, Urinary; Benzenesulfonates; Cystitis; Dogs; Female; Humans; Hypochlorous Acid; Middle Aged; Ureteral Diseases; Vesico-Ureteral Reflux

In a retrospective review, 52 patients with interstitial cystitis have been studied. Patients with persistent lower tract irritative symptoms, repeatedly sterile urine, and negative urine cytology must be suspected of having interstitial cystitis, and a diagnosis of urethral syndrome in such patients is highly questionable until cystoscopy under anesthesia has been performed. We believe that the finding of multiple petechia-like hemorrhages (glomerulations) on the second distention of the bladder is the hallmark of interstitial cystitis, and that a reduced bladder capacity and a Hunner's ulcer represent a different (classic) stage of this disease. In all stages, the characteristic histologic finidng is submucosal edema and vasodilation. The presence of eosinophils and mast cells is variable, and even in the classic disease the muscularis often appears to be normal. Immuno fluorescent studies and laboratory tests, including the fluorescent antinuclear antibody test (FANA), have not helped us to diagnose (or investigate) interstitial cystitis. Bladder instillations with a 0.4 per cent solution of oxychlorosene sodium (Clorpactin WCS-90) have provided remarkable relief for many patients with this disease, particulary those with the classic form.

Topics: Adult; Anti-Infective Agents; Benzenesulfonates; Cystitis; Cystoscopy; Female; Humans; Hypochlorous Acid; Male; Middle Aged; Retrospective Studies; Sulfonic Acids; Urinary Bladder

Topics: Anti-Infective Agents, Local; Benzenesulfonates; Cystitis; Cystitis, Interstitial; Halogens; Hydrocarbons, Halogenated

Topics: Anti-Infective Agents, Local; Benzenesulfonates; Cystitis; Cystitis, Interstitial; Halogens; Hydrocarbons, Halogenated

Topics: Anti-Infective Agents, Local; Benzenesulfonates; Cystitis; Cystitis, Interstitial; Halogens; Hydrocarbons, Halogenated

Topics: Anti-Infective Agents, Local; Benzenesulfonates; Cystitis; Cystitis, Interstitial; Halogens; Hydrocarbons, Halogenated

Topics: Anti-Infective Agents, Local; Benzenesulfonates; Cystitis; Halogens; Hydrocarbons, Halogenated; Tuberculosis; Tuberculosis, Urogenital